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Anterior advancement of the tibial tuberosity in the treatment of the patellofemoral pain syndrome

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Summary

Seventy-two patients with disabling patellofemoral pain were treated with anterior advancement of the tibial tuberosity. In a follow-up examination 1–5 years (mean 2.5) postoperatively, 57% of the patients had improved, 19% were unchanged, and 24% were worse. The high failure rate is disturbing, and we warn against too frequent use of the anterior tuberosity advancement procedure. Patients with patellofemoral pain should be approached by establishing a specific diagnosis and applying a specific treatment. In this study we concluded that the only patients who might benefit from the operation were those with grade I-11 changes of the patellar cartilage.

Zusammenfassung

Bei 72 Patienten mit krankmachenden Schmerzen im Femoropatellargelenk wurde eine operative Ventralverlagerung der Tuberositas tibiae vorgenommen. Bei einer Nachuntersuchung 1–5 Jahre (durchschnittlich 2,5 Jahre) nach der Operation war bei 57% der Patienten eine Besserung zu verzeichnen. Bei 19% war keine Änderung and bei 24% eine Verschlimmerung eingetreten. Die hohe Rate der Mißerfolge hat zu einer Verunsicherung geführt, and als Schlußfolgerung daraus wird vor einer allzu häufigen Anwendung dieser Operation gewarnt. Patienten mit femoropatellaren Schmerzen sollten einer spezifischen Diagnostik and Therapie zugeführt werden. Die einzigen Patienten in dieser Studie, die möglicherweise von dieser Operation einen Nutzen gehabt haben, waren jene mit einem Knorpelschaden Grad I–II an der Kniescheibe.

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Correspondence to J. Karlsson.

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Karlsson, J., Lansinger, O. & Sward, L. Anterior advancement of the tibial tuberosity in the treatment of the patellofemoral pain syndrome. Arch. Orth. Traum. Surg. 103, 392–395 (1985). https://doi.org/10.1007/BF00435447

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Keywords

  • Public Health
  • Failure Rate
  • Specific Treatment
  • Pain Syndrome
  • Specific Diagnosis